Heart, liver, kidney and bone disease are now important causes of illness in people living with HIV. Having these conditions identified without delay is important so that the right treatment can be started. The British HIV Association (BHIVA) set guidelines for routine monitoring of adults living with HIV in the UK in 2011. During 2015, they did an audit to check whether the guidelines were being followed.
Some guidelines were widely followed. Everyone taking HIV treatment should have their viral load tested at least every six months, and this was the case for 90% of people. Staff should assess adherence to treatment at least once a year, and this happened for 93% of people. Most people had blood tests for hepatitis B and C.
But the audit highlighted some problems:
- People with HIV should have their risk of heart disease and other cardiovascular problems assessed every three years, but this only happened for 45% of people, even in those over the age of 50.
- Doctors should ask all patients at least every two years about whether they smoke, but there was only evidence of this for 66% of people.
- Everyone should have a sexual health screen at least once a year (more often for some people), but this had only happened for 66% of people.
- All women with HIV should have cervical screening each year, but this was only provided for 53% of women, with a further 22% advised to go to their GP or a sexual health clinic for it.
- Everyone over the age of 50 should have their risk of a bone fracture assessed every three years, but this was only done for 17% of people in this age group.
BHIVA says that one problem might be confusion among HIV doctors about what they should be providing, and what GP surgeries should be doing. “Improved communication between HIV and primary care services would streamline and improve care,” they say.
The full article can be read here.